Anxiety in children and adolescents with autism spectrum disorders
Section snippets
Methods
This review was based on a systematic search of published articles available through August of 2008. The Psych-Info and Medline online databases were searched concurrently for entries containing any combination of the following terms: (1) autism, asperger(s), or pervasive developmental disorder and (2) anxiety or anxious. Abstracts of identified articles were then screened for the following inclusion criteria: (a) the target population included school-age children or adolescents (between 6 and
Prevalence
Large-scale epidemiological studies have not been conducted on the prevalence of co-occurring anxiety disorders in ASD. However, the studies reviewed here indicate that between 11% and 84% of children with ASD experience some degree of impairing anxiety (Table 1). In the only studies to examine diagnosed anxiety disorders in ASD, de Bruin, Ferdinand, Meester, de Nijs, and Verheij (2006) found that slightly more than 55% of the sample met criteria for at least one anxiety disorder and Simonoff
Discussion
Although the relationship between ASD and anxiety is not fully understood at this time, it is evident that anxiety is a problem for a substantial number of individuals with ASD. This review was undertaken to: (1) identify areas in which further research is needed, with consideration of some of the methodological limitations seen across the studies reviewed; (2) draw general conclusions about the prevalence, phenomenology, and treatment of anxiety in ASD based on the reviewed literature; and (3)
Conclusions
Despite the lack of firm prevalence data on the co-occurrence of anxiety disorders in youth with ASD, problems with anxiety appear more frequently in youth with ASD than in many other clinical and non-clinical populations. The presentation of anxiety is likely affected by age, level of cognitive functioning, ASD-specific difficulties (e.g., over-arousal), and degree of social impairment. Further research is needed to identify the risk factors and etiological pathways for anxiety in ASD. As the
Acknowledgement
This project was supported by a grant from the National Institute of Mental Health [1K01MH079945-01; PI: S. W. White].
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References marked with an asterisk indicate studies of ASD included in the review.